The primary aim of this R21 proposal submitted in response to NIDA RFA-DA-08-005 is to adapt Integrated Family and Cognitive-Behavioral Therapy-HIV Prevention Intervention (IFCBT-HIVPI) to prevent HIV among black South African drug users. During the one-year study proposed, a total of 120 HIV-negative, black South African drug users aged 18 to 40 years and stratified by gender will be randomly assigned to experimental (i.e., IFCBT-HIVPI) and comparison (Brief Psychoeducation Curriculum for HIV Prevention;BPEC-HIVP) conditions. These 120 HIV-negative subjects will be recruited from a pool of 660 adult drug users enrolled in the South African NEURO-HIV Epidemiologic Study that is examining neuropsychological and social-behavioral HIV risk factors among drug users in the Pretoria region. An IFCBT-HIVPI model suitable for use with black drug users in South Africa will be derived through an iterative series of adaptations to the HIV prevention intervention as it is delivered during two, consecutive 16-week intervention delivery cycles. An assessment battery comprised of a standardized interview on HIV risk behavior, neuropsychological executive function tests, tools designed to assess behavior change processes targeted by IFCBT-HIVPI, urine drug testing, and serologic tests of HIV will also be administered before (1 baseline assessment), during (1 process assessment), and after (1 outcome assessment) the intervention interval. Assessment battery administration will provide the basis to accomplish the second study aim to adapt instruments designed to assess attitudes and behavior change skills targeted by IFCBT-HIVPI. The proposed project will also adapt and develop an Interventionist Training Manual designed to train clinicians to deliver the IFCBT-HIVPI model to drug users in South Africa. The HIV prevention intervention model we are proposing to adapt for use with high risk drug users in South Africa has demonstrated its feasibility and portability in the US when delivered to adult female drug users who are pregnant. The IFCBT model has also demonstrated efficacy when used as an adolescent drug treatment in the US. Through well-established partnerships with South African colleagues and the University of Pretoria research site, our combined goal is to reduce the catastrophic spread of HIV among drug users in South Africa by adapting a manual-based HIV prevention model developed in the US while building upon accomplishments of our epidemiologic HIV research in South Africa. PROJECT NARRATIVE. The critical need to develop science-based HIV prevention interventions for drug users in South Africa is dramatically underscored by the overwhelming extent of the pandemic in the region with an estimated 5.5 million people infected with HIV/AIDS and estimates of HIV infection among drug using females approaching 50%. To help reduce the spread of HIV in sub-Saharan Africa, the proposed study seeks to adapt a prevention intervention model with proven efficacy in the US for use with South African drug users at highest HIV risk.